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On-site Medical Care: The Benefit of the Future?


Large firms such as The Walt Disney Co. and American Express Co., eager to curb fast-rising health care costs, have opened their own health centers, where doctors and nurses provide medical care to workers just steps away from their desks.

Some clinics are equipped with exam rooms, X-ray machines and pharmacies. Some provide on-site appointments with dentists, dermatologists, psychiatrists and specialists treating life-threatening illnesses.

Employers see this as a way to get more for their money, but skeptics wonder about the care and whether workers are surrendering their medical privacy. Is corporate medicine a big money-saver?

It's in employers' self-interest to have a healthy workforce, say proponents. And that's why on-site nursing and medical care is gaining popularity. American Express offers free or low-cost blood tests, physicals, allergy shots and prescriptions to employees and family members. Some sites include boxing classes, yoga and massage therapy.

The company sees the payoff in improved health and productivity on the job. It's expanding to preventive services to keep employees from getting sick and running up big medical bills.

As of 2015, nearly 30 percent of companies with more than 5,000 workers had on-site or near-site clinics, up from 24 percent in 2013. These sites offer some type of primary care, according to benefits consultant Mercer. Many treat workers' families and include fitness centers with exercise equipment, with services provided at no charge to employees.

Companies that operate clinics for employers — Healthstat, Marathon Health, Premise Health and QuadMed — have jumped into the market, operating about 18 percent of worksite clinics, so says another benefits consultant, Towers Watson. Advocate Medical Group, based in Downers Grove, Illinois, has a division called Advocate at Work that operates worksite clinics for about 120 companies.

While the majority — 64 percent, according to Towers Watson — contract the on-site clinic to a vendor, 23 percent of companies directly operate the on-site medical clinic.

What are the benefits to you? Encouraging exercise, keeping workers healthier, reducing absenteeism and cutting benefit costs. On-site medical care reduces the amount of time workers spend away from work. These centers can help companies identify occupational health and safety risks, such as poorly designed workstations that result in back and neck problems.

Two-thirds of large employers with on-site health facilities said in 2015 that they'd expand such centers. However, we will have to see what happens to various provisions of the Affordable Care Act before we make any predictions about how on-site care may advance.

Still, if the past is prologue, not everyone was on board anyway. A health economist from Baylor University questioned whether clinics yield significant cost savings. The thinking here is that the most health-conscious employees would make the most use of them and that the unhealthiest and most expensive employees would be unlikely to get needed preventive care. The payoff from preventive medicine comes years later — perhaps after employees have left your company.

Some employees may fear their employers will use their health information against them.

But they keep on coming. The latest employer-sponsored centers have nurse practitioners and physician assistants on staff, full time and part time. Some feature physical therapists and nutritionists. Half offer pharmacies. The on-site health clinic at Facebook's Menlo Park, California, headquarters has a chiropractor.

A health clinic at Laitram Machinery in New Orleans has decreased hospital emergency room visits by 26 percent since 2010 and has seen one measure of health — blood pressure, cholesterol or body fat percentage — reduced in eight out of 10 workers. Laitram uses Winooski, Vermont-based Marathon Health to operate the clinic, with its fitness and nutrition center run by LifeStart Wellness Network of Chicago.

This is quite an improvement over what Laitram had been projecting: a monthly healthcare premium curve for employees that showed a 40 percent increase over six years.


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